Our 20+ years in business has afforded us a great deal of insight and understanding of the challenges of medical billing and reimbursement. So, whether you are an existing AMBS client, considering utilizing our services or just want to stay "in the know," follow our blog to keep better informed.

About Me

Vice President & Co-Founder of AMBS, Inc. www.AMBSinc.com
Greg has been involved with the business services and outsourcing industry for the last 20 years, helping some of the largest Fortune 500 corporations, and small to medium sized healthcare practitioners with their outsourcing needs.

Thursday, March 29, 2012

Have You Completed
Your 5010 Implementation?

There are steps to ensure that your upgrade
is a smooth one: establish a line of credit and check partner readiness

Recently, the Centers for Medicare & Medicaid Services (CMS)
announced it will not initiate enforcement action against any HIPAA covered
entity for an additional three (3) months, through June 30, 2012,for the
updated HIPAA transaction standards (ASC X12 Version 5010, NCPDP Versions D.0
and 3.0).

Although much progress has been made in the successful receipt
and processing of claims in the Version 5010 format, CMS is aware that there
are still challenges and issues impeding an industry wide upgrade.

During these additional 90 days in which CMS will not initiate
enforcement penalties, you should collaborate more closely with trading
partners on appropriate strategies to resolve any remaining problems. Two steps
providers can take to ensure a smooth upgrade are:

Establishing a line of credit: To avoid potential cash flow disruptions, providers
should consider establishing or increasing a line of credit. By doing so,
they can prepare for possible delays and denials in payer claims
reimbursements if noncompliant Version 5010 transactions are submitted.

Check partner readiness: Because a provider's Version 5010 upgrade can be
dependent upon his or her vendor, it is important for providers to be
aware of their vendor's transition status. If your vendor is behind
schedule for Version 5010 adoption, get confirmation of their timeline to
be compliant, and encourage them to take action so that your system will
be prepared to handle your claims.

Other steps to prepare for the Version 5010 upgrade can be found
on the Version 5010: Ensuring a Smooth Transition Fact Sheet, which provides an
overview of several actions providers can take to maintain continuity of
operations for their practices as they prepare to complete Version 5010
testing.

Keep Up to Date on Version 5010 and ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you
prepare, and to download and share the implementation widget today!

Wednesday, March 14, 2012

HIPAA 5010 Transition Problems

Many Physicians experience problems during 5010 Transition

On January 1, 2012, all electronically submitted HIPAA covered health insurance claims were supposed to be submitted using the 5010 platform. Although CMS had previously announced it would not take any enforcement action against any plan or provider who was not 5010 ready until after March 1, 2012, the January 1 deadline for compliance remained in effect.

Perhaps the most consistent reports heard during the transition were that the problems – whatever they were – were someone else’s fault. Clearinghouses blamed Health Plans (both commercial and government) and Health Plans blamed providers, clearinghouses or practice management software programs. There were so many fingers being pointed at others over the past two months, it is a wonder there wasn’t a major up-tick in the number patients showing up in ERs with broken fingers!